Abstract
Background and Objective: To examine the impact of adjuvant radiotherapy (RT) and surgical technique on survival in retroperitoneal soft-tissue sarcoma. Methods: A retrospective analysis was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by IMPAC® Medical Systems (Sunnyvale, CA). Patients who received definitive surgery with negative or microscopic-positive margins were included. Multivariate analysis was performed using the Cox proportional hazards model. Survival curves were estimated by the Kaplan-Meier method and were compared for statistical significance (P<0.05) using the log-rank test. Results: Two hundred sixty-one patients met inclusion criteria. The median follow-up was 59 months (range 0.2-186 months). The 5-year cause-specific survival (CSS) and local failure-free survival (LFFS) were 73% and 66%, respectively. Grade, margin status, and histology were independent predictors for CSS (P<0.05). Adjuvant RT was associated with a significant improvement in LFFS over surgery alone (hazard ratio=0.42, 95% confidence interval 0.21-0.86, P<0.05). Patients receiving simple excision and RT had a 5-year LFFS of 88%, significantly higher than wide resection with or without RT (log-rank, P<0.05). Conclusion: Adjuvant RT is associated with a lower risk of local relapse compared to surgery alone. The impact of surgical technique on adjuvant RT efficacy warrants further study.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 345-350 |
| Number of pages | 6 |
| Journal | Journal of Surgical Oncology |
| Volume | 101 |
| Issue number | 5 |
| DOIs | |
| State | Published - Apr 1 2010 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Surgery
- Oncology
Cite this
Radiotherapy and extent of surgical resection in retroperitoneal soft-tissue sarcoma : Multi-institutional analysis of 261 patients. / Sampath, Sagus; Hitchcock, Ying J.; Shrieve, Dennis C.; Randall, R; Schultheiss, Timothy E.; Wong, Jeffrey Y.C.
In: Journal of Surgical Oncology, Vol. 101, No. 5, 01.04.2010, p. 345-350.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Radiotherapy and extent of surgical resection in retroperitoneal soft-tissue sarcoma
T2 - Multi-institutional analysis of 261 patients
AU - Sampath, Sagus
AU - Hitchcock, Ying J.
AU - Shrieve, Dennis C.
AU - Randall, R
AU - Schultheiss, Timothy E.
AU - Wong, Jeffrey Y.C.
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Background and Objective: To examine the impact of adjuvant radiotherapy (RT) and surgical technique on survival in retroperitoneal soft-tissue sarcoma. Methods: A retrospective analysis was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by IMPAC® Medical Systems (Sunnyvale, CA). Patients who received definitive surgery with negative or microscopic-positive margins were included. Multivariate analysis was performed using the Cox proportional hazards model. Survival curves were estimated by the Kaplan-Meier method and were compared for statistical significance (P<0.05) using the log-rank test. Results: Two hundred sixty-one patients met inclusion criteria. The median follow-up was 59 months (range 0.2-186 months). The 5-year cause-specific survival (CSS) and local failure-free survival (LFFS) were 73% and 66%, respectively. Grade, margin status, and histology were independent predictors for CSS (P<0.05). Adjuvant RT was associated with a significant improvement in LFFS over surgery alone (hazard ratio=0.42, 95% confidence interval 0.21-0.86, P<0.05). Patients receiving simple excision and RT had a 5-year LFFS of 88%, significantly higher than wide resection with or without RT (log-rank, P<0.05). Conclusion: Adjuvant RT is associated with a lower risk of local relapse compared to surgery alone. The impact of surgical technique on adjuvant RT efficacy warrants further study.
AB - Background and Objective: To examine the impact of adjuvant radiotherapy (RT) and surgical technique on survival in retroperitoneal soft-tissue sarcoma. Methods: A retrospective analysis was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by IMPAC® Medical Systems (Sunnyvale, CA). Patients who received definitive surgery with negative or microscopic-positive margins were included. Multivariate analysis was performed using the Cox proportional hazards model. Survival curves were estimated by the Kaplan-Meier method and were compared for statistical significance (P<0.05) using the log-rank test. Results: Two hundred sixty-one patients met inclusion criteria. The median follow-up was 59 months (range 0.2-186 months). The 5-year cause-specific survival (CSS) and local failure-free survival (LFFS) were 73% and 66%, respectively. Grade, margin status, and histology were independent predictors for CSS (P<0.05). Adjuvant RT was associated with a significant improvement in LFFS over surgery alone (hazard ratio=0.42, 95% confidence interval 0.21-0.86, P<0.05). Patients receiving simple excision and RT had a 5-year LFFS of 88%, significantly higher than wide resection with or without RT (log-rank, P<0.05). Conclusion: Adjuvant RT is associated with a lower risk of local relapse compared to surgery alone. The impact of surgical technique on adjuvant RT efficacy warrants further study.
UR - http://www.scopus.com/inward/record.url?scp=77950534966&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77950534966&partnerID=8YFLogxK
U2 - 10.1002/jso.21474
DO - 10.1002/jso.21474
M3 - Article
C2 - 20119974
AN - SCOPUS:77950534966
VL - 101
SP - 345
EP - 350
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 5
ER -